Monday, March 23, 2009

News Clipping Archives

 

Maryland / Regional

 

Gov. O'Malley Announces $1.5 Billion in Funds to Protect MD's Health

Care Safety Net (BAYNET.COM - Southern Maryland News)

Number Of Premature Births In Maryland Drops 4%- USA (Medical News Today)

Confronting a health emergency in West Baltimore (Daily Record)

As tb rates go down- drug resistance causes worry (Daily Record)

Stage set for group in its new residence (Catonsville Times)

Computerized records giving doctors new tool (Baltimore Sun)

Dead Infant Girl Found in Pr. George's Lake (Washington Post)

Acupuncture helps addicted inmates (Baltimore Sun)

Searching for a Cure-All  (Washington Post)

Worcester Co. Developmental Center Employee Charged With Theft (wboc.com)

 

National / International

 

Judge Orders FDA to Reconsider Limits on Morning-After Pill for Minors (Washington Post)

Study Finds Eating Red Meat Contributes to Risk of Early Death (Washington Post)

EPA: Global Warming Threatens Public Health- Welfare (Washington Post)

Reducing Hospital Infections- Late-Term Abortion Trial and Rising Vasectomy Rates

(New York Times)

Vital Signs - Childhood: Combing Through Wet Hair May Be Best Way to Find Lice

(New York Times)

South Africa tries treating TB patients at home (Washington Post)

WHO: Money- drugs needed to rein in new TB strains (Washington Post)

China Clears J&J in Probe of Baby-Product Chemicals (Wall Street Journal)

 

Opinion

 

Costly Home Health Care (New York Times)

Food for Thought (Washington Post)

Active kids (Cumberland Times-News)

A prescription for healthy babies (Baltimore Sun)

Right to rely less on group homes (Baltimore Sun)

 

 

 

 

Maryland / Regional

 

Gov. O'Malley Announces $1.5 Billion in Funds to Protect MD's Health Care Safety Net

 

BAYNET.COM (Southern Maryland News)

Monday- March 23- 2009

 

MARYLAND - On March 23- Governor Martin O’Malley joined by U.S. Senator Benjamin L. Cardin- Department of Health and Mental Hygiene Secretary John M. Colmers- and other state and local healthcare leaders- today highlighted the nearly $1.5 billion in American Recovery and Reinvestment Act funds to protect Maryland’s healthcare safety net.  These funds will help fortify Maryland’s expanded health care program- support community clinics- address the needs of underserved children and protect tens of thousands of healthcare jobs.

 

“Thanks to the leadership of President Obama and Maryland’s federal delegation- Maryland is receiving nearly $1.5 billion in federal Medicaid resources to cover the healthcare costs of thousands of Maryland families-” Governor O’Malley said.  “More and more people are either having their work hours cut- or are losing their jobs altogether - and too often are forced to choose between putting food on the table or seeing a doctor.  Because of these dollars- and because of the investments we’ve already made- Maryland’s health care safety net remains strong and stable - even during this national economic crisis.”

 

“Maryland families are hurting as we face the most serious economic downturn in decades-” said U.S. Senator Benjamin L. Cardin- a member of the Senate Budget Committee.  “Healthcare should be a right for all Americans- and I am pleased that the economic recovery package includes funding to help low-income Marylanders continue to receive health care through Medicaid.  It also provides a substantial subsidy for workers who have been laid off so they can continue to pay for health care coverage.”

 

Governor O’Malley made the announcement at Maryland’s kick-off for national “Cover the Uninsured Week”- a statewide effort by DHMH- hospitals- local health departments and community clinics to promote healthcare programs and services and to enroll eligible families and children into existing programs. 

 

“This timely investment in health care means Maryland can continue to serve those who need help most-” said John M. Colmers- DHMH Secretary.  “Without these funds provided by our health care champions in Congress and the White House- over 50-000 people could lose the coverage they now have under our Medicaid program. The number of people who need our help is likely to grow as we struggle to recover from the loss of jobs and healthcare benefits.” 

 

“The American Recovery and Reinvestment Act will create and save 66-000 Maryland jobs over the next two years-” added Gov. O’Malley. “This includes doctors- nurses and thousands of other health care workers who are able to continue to save lives and treat the sick and injured throughout Maryland thanks to this investment.”

 

Maryland’s American Recovery and Reinvestment Act website can be found at www.recovery.maryland.gov. 

 

© 2005-2009 Bay Media Services & The Bay Net.

 

 

 

 

Number Of Premature Births In Maryland Drops 4%- USA

 

Medical News Today

Monday- March 23- 2009

 

There is good news for babies born in Maryland- says the Maryland Department of Health and Mental Hygiene (DHMH). The number of babies born prematurely (before 37 weeks of pregnancy) dropped by over 4 percent from 2006 to 2007 according to the Center for Disease Control's National Center for Health Statistics. Premature births were down in all racial and ethnic groups in the state. Similarly- the percentage of low birth weight babies (born at less than 2500 grams or 5 ½ pounds) in Maryland fell by over 3 percent in 2007.

 

"These key indicators show that the health of Maryland's mothers and their babies is improving ahead of the national curve-" said DHMH Secretary John M. Colmers. "Yet- we know there is much more to do to ensure every pregnant woman gets the care she needs so every child has a healthy start in life."

 

The latest 2007 numbers suggest that Maryland program- "Babies Born Healthy" is having a positive impact. Maryland's broad public health initiative increases access to health services for women before they become pregnant- improves patient safety for mothers and infants in Maryland hospitals- establishes strong standards for obstetrical and neonatal care- and promotes access to high-risk pregnancy care through partnerships with the state's academic medical centers.

 

Compared to Maryland's numbers- both premature births and low birth weight dropped by just 1 percent nationally in 2007- according to the CDC's Vital Statistics Report of Preliminary 2007 Birth data. The decrease seen in Maryland's premature and low birth weight babies is significant because these are the leading causes of infant deaths in the first year of life.

 

"This confirms that Maryland's comprehensive approach is making a positive difference-" says DHMH Deputy Secretary for Public Health- Frances Phillips-. "Our goal now is to extend this success to improve the health of every pregnant mother and newborn in Maryland. Also- we must we regain the progress we've seen in recent years in reducing teenage births."

 

Unfortunately- some teen birth rates increased slightly in 2007 - both in Maryland and across the United States - according to data also released by the CDC. Teen births in Maryland remain well below the national average at 33.6 births per thousand females age 15 to 19- compared to 41.9 per thousand nationwide. In the youngest age group- age 10 to 14- births fell in Maryland in 2007 while they remained stable nationally. Although teen births have increased slightly for the past two years- there has been a substantial decrease since 2000. Maryland teen births have fallen 17 percent since 2000- with a 12 percent decline nationally over the same period.

 

To access the CDC's National Vital Statistics Report- Preliminary 2007 Birth Data- go here.

 

Source

Maryland Department of Health and Mental Hygiene

Copyright 2009 Medical News Today.

 

 

 

 

Confronting a health emergency in West Baltimore

 

By Samuel L. Ross- M.D.

Daily Record

Monday- March 23- 2009

 

Our emergency room doctors and nurses know them by name—the dozens of regulars who make their way again and again to the Bon Secours Hospital emergency room on West Baltimore Street.

 

Many have untreated chronic conditions such as heart disease- cancer- asthma and diabetes. Many are drug or alcohol abusers- and some face mental health issues. And many are uninsured.

 

The emergency room is their private doctor’s office or personal drop-in clinic — not at all what the E.R. was intended or equipped to be.

 

This overuse of a costly emergency department is just one of the many vexing problems that threaten the financial health of our West Baltimore ministry.

 

Bon Secours remains committed to the community it serves- but we- like other inner-city hospitals- are losing millions of dollars every year in a system that often does not work well for disadvantaged communities.

 

Such losses would be more tolerable if we were achieving our overarching goal — a healthier community. While we are doing many things well- such as providing substance abuse and mental health services- the reality is that despite our best efforts- the overall health of the people of West Baltimore is not improving.

 

Troubling statistics

 

Consider some statistics compiled recently by Baltimore City Health Commissioner Joshua Sharfstein:

 

·         Today- in the neighborhoods served by Bon Secours- residents die from heart disease at a rate that is 35 percent higher than that of the city as a whole. Deaths from diabetes and HIV/AIDS are also substantially higher than in the entire city.

 

·         Residents of certain areas along the West Baltimore Street corridor have a life expectancy of 64.6 years- compared to almost 71 years for the entire city.

 

·         A baby born in some West Baltimore neighborhoods will live- on average- 20 years less than one born in certain affluent neighborhoods in North Baltimore and elsewhere- where consistent primary care is more accessible.

 

These sobering numbers should be a cause for alarm for residents- the city’s elected officials- health care providers and state leaders. Indeed- many families in these areas are living through a health care crisis.

 

An action plan

 

What do we do in response?

 

First- we must openly and honestly acknowledge the problem. State and local health officials- along with elected officials- community leaders- the nonprofit sector and residents of the region must agree that the status quo is unacceptable and look for ways to improve health care in areas such as West Baltimore.

 

Today- that area’s health care system is poorly constructed and fails to provide the comprehensive services the community needs.

 

Most glaring is the lack of access to critical health care services- particularly primary and preventive care. Overall- there is one primary care physician for every 2-100 residents — less than half the target set by the American Academy of Family Physicians.

 

Without adequate access to primary and preventive care- residents often fail to treat minor ailments that turn into serious problems. Those with chronic conditions such as diabetes- hypertension and asthma often find it more difficult to receive ongoing treatment. Because of that- treatable ailments become life-threatening emergencies.

 

That dysfunction can be seen clearly in how the community uses Bon Secours Hospital. Without access to primary care- many area residents resort to using the hospital’s emergency department for non-emergency problems- in many cases repeatedly. Over the three-year period ending in 2008- a group of 50 patients had a total of 2-287 visits to the emergency room.

 

Second- we can visualize and create a better designed system in which residents of West Baltimore have access to a primary care doctor either in an office setting or in an urgent or walk-in center- as well as high-quality sub-specialty care for chronic ailments and hospital services for those who truly need them.

 

The system is broken

Such as system must also address other critical needs — unemployment- low educational attainment- and inadequate nutrition among them — that harm the community’s overall health. Implementing such a system will take cooperation- planning and resources.

 

For now- Bon Secours continues to do the best it can within a broken system. But we also are pondering an uncertain future. Our ministry is rooted in compassion- healing and liberation. We are also required to be good stewards of our resources.

 

How long can we continue to lose significant amounts of money in the service of a health care system that is failing to make our community healthier?

 

That is a question Bon Secours and others must confront today.

 

We urge local and state elected officials- health care regulators- other health care providers and members of the broader community to acknowledge the urgent reality and consider how we can partner to improve the health of people in our most disadvantaged areas.

 

Dr. Samuel Ross is chief executive officer of Bon Secours Baltimore Health System.

 

Copyright 2009 Daily Record.

 

 

 

 

As tb rates go down- drug resistance causes worry

 

Associated Press

Daily Record

Monday- March 23- 2009

 

Even as tuberculosis rates decline in the United States- drug-resistant strains of the disease are showing up in states with large immigrant populations and are becoming increasingly hard to treat.

 

Researchers are concerned about this trend while funding for labor-intensive disease control programs is being cut in cities such as San Francisco- which has the highest TB rates in the country.

 

Drug resistance develops when patients start feeling better and interrupt their treatment- giving bacteria an opportunity to develop a defense against the medication.

 

The picture is grim- and World TB Day on Tuesday is an attempt to raise awareness of a disease that infects about 9 million people- particularly in Asia and Africa. About five percent of those patients are immune to the best drugs. About 2 million die annually.

 

Immigrant communities in states such as California are particularly vulnerable because many people are foreign born or travel frequently to countries where TB is a greater risk- such as Mexico- India and China.

 

California leads the nation with 2-696 TB recorded cases in 2008— and with 451 cases of drug-resistant TB identified between 1993 and 2007. About 83 percent of these drug-resistant cases involve immigrants born abroad.

 

"California- having so much exposure to the world via immigration and travel- is particularly at risk-" said Gil Chavez- deputy director of the California Department of Public Health.

 

Patients with multidrug-resistant tuberculosis do not respond to the most commonly used antibiotics. Of even greater concern is extensively drug resistant tuberculosis- which is even more resistant to an even greater number of drugs- making treatment extremely difficult.

 

A statewide analysis of drug-resistant TB cases between 1993 and 2006 found the proportion of patients that were one drug away from becoming extensively drug resistant grew from 7 percent to 33 percent.

 

"It's a wake-up call-" said Ritu Banerjee- a researcher with the Division of Infectious Diseases at the University of California- San Francisco- lead author on the paper published in the Clinical Infectious Diseases journal in 2008.

 

With extensively resistant TB- the patient can lose lung tissue and need surgery- pushing the cost of treatment up to $1 million- with no guarantee of survival- said Kenneth Castro- director of the Centers for Disease Control's Division of Tuberculosis Elimination.

 

"You get a couple of these patients and you can bankrupt a city program-" he said.

 

After a TB spike in the 1990s- San Francisco adopted a hands-on approach to treatment.

 

Patients travel to the city's tuberculosis control clinic so staff can deliver their daily dose of drugs. Those who cannot visit the clinic because of work schedules- illness or other hurdles are seen by field health care workers like Virgilio Comia.

 

With a nod and a smile — most of his patients do not speak English- and they communicate in signs — he gives each one a handful of pills- and stays until they have swallowed them all.

 

Looking for his first patient of the day- he knocks on a garage door. An elderly Chinese man slumps over a narrow table- still weak though it had been two months since he was released from the hospital.

 

The garage was partitioned into four dark- windowless cubicles- each one home to other recent immigrants.

 

"You can see- it's like a refugee camp in there-" Comia said.

 

Tuberculosis- long a disease associated with crowded conditions- is spread through coughing and sneezing.

 

Comia's patients include a Cambodian grandmother who shares a single-room apartment with six relatives- and a homeless man in one of the city's shelters.

 

Comia's persistence ensures they complete their course of treatment. Now budget cuts are endangering this kind of proactive approach to TB.

 

The city' ability to proactively test in high-risk areas and to treat latent TB cases before they become active has been hurt- said Jennifer Grinsdale- program manager and epidemiologist with the TB Control Section of the city Department of Public Health.

 

"Anywhere from two to 10 years from now- we'll see the impact for this-" she sai

 

Copyright 2009 Daily Record.

 

 

 

 

Stage set for group in its new residence

Theater group finds home on Spring Grove campus

 

By Kevin Rector

Catonsville Times

Wednesday- March 18- 2009

 

The Catonsville-based Heritage Players theater group will take the stage for the first time in almost two years March 19 with a debut performance at its new home in the Spring Grove Hospital Center's Rice Auditorium.

 

The group will perform Neil Simon's 1976 play "California Suite-" a collection of four vignettes about couples staying in a hotel suite in California.

 

The Heritage Players spent about 12 years performing at the Catonsville United Methodist Church- on Melvin Avenue- before being asked to leave in 2007 because congregation growth had caused the church to need more space for its own programs.

 

The theater group moved to the Rice Auditorium on the hospital center campus in September after Spring Grove officials agreed to let them use the space in exchange for free performances for patients- said Robin Trenner- the group's president.

 

"Spring Grove has been really- really accommodating-" Trenner said.

 

The theater group- which began in Pikesville in 1975 and spent 20 years there before moving to Catonsville- hopes to again start performing two shows a year- she said.

 

According to Eric Stein- the play's director and a native of Arbutus- group members are excited to start performing again.

 

"Heritage is trying to make that return to being a viable community theater group-" he said.

 

Last month- local theater took a hit when the Community College of Baltimore County-Catonsville ended its residency agreement with the non-profit theater group Winters Lane Productions.

 

Stein said that showed how important it is for a community theater group to have a home.

 

"It means everything-" he said.

 

"We've been very lucky that the hospital center folks have been willing to work with us-" he said.

 

Stein echoed Trenner's praise of Spring Grove officials- and said the officials have been extremely accommodating in helping the group prepare the auditorium as its new home.

 

"This much access to a space is priceless-" he said.

 

Angela Matsis- the show's stage manager and a native of Catonsville- said she is excited the long transition process is over.

 

"It's like moving a house. You don't know how much stuff you've collected until you're packing it all up-" said Matsis- who is engaged to Stein.

 

But the experience wasn't entirely bad- Matsis said.

 

The all-volunteer group is always looking for new members who offer different talents and experience- and the two-year break in performances forced group members to branch out and make new connections in the tightly knit Baltimore theater community- Matsis said.

 

"In retrospect- I think it helped in broadening our prospects-" she said.

 

Simon's play features four vignettes about couples from New York- Philadelphia- Chicago and London who face vastly different issues during their travels- said Stein.

 

While the New York couple deals with divorce and child custody- the Philadelphia couple deals with adultery. The couple from London deals with fame and sexuality and the visitors from Chicago -- two couples -- deal with vacation tensions.

 

The comedy combines "slapstick humor" with "verbal sparring-" Stein said.

 

The March 19 show starts at 8 p.m. and is a "pay what you can" performance- meaning audience members are asked to contribute as much as they can.

 

All subsequent performances- which are on March 20- 21- 27 and 28 at 8 p.m. and March 29 at 2 p.m.- are $10 for adults and $8 for seniors and students.

 

Proceeds from the show will go toward buying new equipment to upgrade the auditorium's lighting system and toward the hospital's patient fund- Trenner said.

 

The Heritage Players will share the Rice Auditorium with the Free State Theatre Organ Society- which holds occasional concerts there.

 

"They've had a pretty long tenure here-" Stein said- "and we hope to do the same."

 

Copyright 2009 Catonsville Times.

 

 

 

 

Computerized records giving doctors new tool

But some fear loss of privacy with U.S. health information network

 

By Matthew Hay Brown

Baltimore Sun

Monday- March 23- 2009

 

As he looks for ways to pay for universal health coverage- President Barack Obama is placing a multibillion-dollar bet on electronic health records.

 

The goal is to get all of the nation's doctors to make the move from clipboard to computer by 2014- thus creating a national health information network that proponents from across the political spectrum say will improve care- advance medical knowledge and save the country tens of billions of dollars annually.

 

That future can be glimpsed in Dundalk- where H. Edward Parker has been a patient at Johns Hopkins Community Physicians for decades. Now the retired high school principal sits down next to his doctor as they use a computer program to review his history- look up the latest research and discuss new courses of treatment.

 

"We have much more meaningful communication" since his doctor's office adopted electronic health records in early 2007- Parker said. "It has made me much more of a participant in my own wellness."

 

Obama has promised to spend $50 billion over five years on health information technology and fulfilled more than a third of the pledge with $17.2 billion in the economic stimulus package to help doctors with the costs of adopting electronic records- the foundation of the national network.

 

"We've got the most inefficient health care system imaginable-" Obama said last month. "We're still using paper. We're still filing things in triplicate. Nurses can't read the prescriptions that doctors have written out. Why wouldn't we want to put that on an electronic medical record that will reduce error rates- reduce our long-term costs of health care and create jobs right now?"

 

The enthusiasm is not unanimous. Privacy advocates warn that the characteristics that make computerizing patient records attractive to health care providers - the wealth of personal information and the ease with which it can be accessed - also make the technology ripe for potential exploitation by employers- insurers and others. There is already a market in which medical data- typically gleaned from insurance records- is bought and sold.

 

"The problem is that the more data that's out there - and it's just going to mushroom - the more difficult it is to keep that private-" said Ashley Katz- executive director of the watchdog group Patient Privacy Rights. "Yes- we can do really- really great things with health [information technology]. We can also do really bad things with it."

 

Dr. Robert M. Kolodner- a psychiatrist and the national coordinator for health information technology- says that patient privacy "is something that we can never afford to forget."

 

"We have to build it into the entire system - the hardware and the software and the networks - from the very beginning-" he said.

 

"On the other hand-" said Kolodner- a Baltimore native- "the safest- the most secure system is one that doesn't move any information. And that doesn't help us- either."

 

There are other concerns surrounding the technology- ranging from the temporary dips in productivity as doctors make the transition from paper charts to computer files to questions about longer-term impacts on the traditional doctor-patient visit.

 

Dr. Pamela Hartzband and Dr. Jerome Groopman- physicians in Boston and professors at Harvard Medical School- warn that technology can divert attention from the patient.

 

"One of our patients has taken to calling another of her physicians 'Dr. Computer' because- she said- 'He never looks at me at all - only at the screen-' " Hartzband and Groopman wrote last year in TheNew England Journal of Medicine. "Much key clinical information is lost when physicians fail to observe the patient in front of them."

 

Obama has identified computerized records- which a patient can "carry" from doctor to doctor- as a key source of savings to help fund his promised health care reform. Proponents see the savings coming principally from some combination of duplicate tests not performed- drug allergies and interactions avoided- and what Kolodner calls "doing the right thing the first time."

 

The $787 billion economic stimulus package included money for both ends of a system that is to link individual electronic health records to the national network. In addition to the $17.2 billion to help the 80 percent of physicians not currently using electronic health records with startup costs- the package also includes $2 billion in grants and loans to develop the national infrastructure.

 

In Maryland- officials have directed two groups to develop plans for a statewide health information exchange. Officials are reviewing those plans- as well as lessons learned by other states.

 

Some health care organizations are ahead of the curve.

 

In the Wyman Park office of Johns Hopkins Community Physicians- Dr. Gary J. Noronha taps out a code on a computer keyboard. On the screen appears the medical information for a 38-year-old man with diabetes and hypertension.

 

With a few keystrokes- Noronha can graph the patient's changing weight- blood pressure and cholesterol counts over years of visits. One section of the electronic health record keeps track of the man's prescriptions- another his allergies. The program can suggest other medicines that might be helpful- enabling the physician to choose from among several options by cost to the patient based on his insurance- while warning away from drugs that could interact harmfully with medication he's already taking.

 

Other prompts remind Noronha that it is time to examine the patient's feet and to order an eye exam. And in a feature that he describes as "kind of fun-" the program can also draw on the patient's medical history- his cholesterol counts and other factors to calculate the likelihood that he will develop coronary heart disease in the next decade.

 

All this is only a demonstration - privacy concerns prevent a reporter from sitting in on an actual patient visit. But as Noronha works his way through what amounts to an electronic chart for the fictitious diabetic- he is showing how the use of health information technology in the examination room has transformed his practice.

 

"It really does allow you ... to think about trends in your patients in a much more sophisticated way than you could in the paper world-" he said.

 

Elsewhere in Maryland- a consortium of eight health centers is in the process of adopting electronic health records. Salliann Alborn sees efficiencies for patients as they travel from doctor to doctor within the system.

 

"By the time the patient walks out of the primary care provider's office and walks down the hall to see- let's say- the mental health provider- that mental health provider can look in there and see the whole visit experience from the primary care provider-" said Alborn- who heads a partnership that provides management services to the consortium.

 

Dr. William Flynt- one of the consortium members- cautions against high expectations. The pediatrician- who graduated from medical school in 1960- says that talk of how technology is going to transform medicine sounds familiar.

 

"I was at the Centers for Disease Control where we watched a lot of the new technology come online - I mean- new technology at that point being the installation of a computer-" said Flynt- executive director of Community Clinic Inc.- in Montgomery County. "This was back in the '70s and '80s- and there were high hopes at that time for linking data."

 

As a retiree of the federal public health service- Flynt gets his health care through the military- which he said has done a "wonderful" job with electronic health records- "but that's in an environment that's highly structured."

 

As for broader implementation- he said- "I'm an epidemiologist. I can immediately see the benefits of having a good data set that you can then mine for all sorts of uses. But it depends entirely on the quality of the information that goes in to start with."

 

Copyright 2009 Baltimore Sun.

 

 

 

 

Dead Infant Girl Found in Pr. George's Lake

 

By Debbi Wilgoren and Matt Zapotosky

Washington Post

Monday- March 23- 2009

 

Two men fishing on Lake Artemesia in Prince George's County yesterday afternoon found the body of an infant girl stuffed into a bag and left in the water- police said.

 

Detectives are still trying to determine the age and identity of the baby- who was found just before 3 p.m.

 

"Apparently some guys were out there fishing and they saw the bag-" Prince George's County police spokesman Larry Johnson said in an interview this morning. "They tried to fish the bag out of the water- and found that it was an infant."

 

Police will work with the medical examiner's officer to determine the cause of death for the baby- and will search for her family- Johnson said.

 

He said county officers also hope to publicize Maryland's "safe haven law-" under which caregivers can leave a newborn baby at a designated safe haven without fear of repercussion if they are feeling overly stressed out or unable to care for the child.

 

Some 47 states had such laws as of 2007- according to the Web site for the Child Welfare Information Gateway. Maryland's version of the law applies to infants who have been born within the previous 10 days.

 

Copyright 2009 Washington Post.

 

 

 

 

Acupuncture helps addicted inmates

Therapy sessions ease cravings- offer hope for a clean life

 

By Kelly Brewington

Baltimore Sun

Monday- March 23- 2009

 

Beyond the iron gate- the fence and the razor wire- 10 inmates in maroon uniforms sit in stillness- listening to the serene sounds of sitar music. Eyes closed- hands folded- they await the tiny pricks of acupuncture needles being inserted delicately in their ears.

 

Ancient Chinese medicine came to Baltimore's jail 16 years ago with the promise of curbing the cravings of drug addiction. Since then- acupuncture has been the centerpiece of a treatment program that serves nearly 700 inmates each year.

 

Modern science has not found solid evidence that it works. Still- the inmates claim that with acupuncture- all they crave are the meditative moments it brings. They say it soothes them and helps clear their cluttered minds to find the strength to confront their addiction.

 

"I've done buprenorphine and methadone- but neither one of them could compare to those needles-" says Derrick Brooks- 42- who's battled heroin his entire adult life. "Those needles put you in touch with stuff that's within you that no pill or nothing else could do."

 

District Judge Jamey H. Hueston thinks every addict should try it. "I am a huge fan of acupuncture-" says Hueston- who presides over the city's drug court. "I have sent people in there kicking and screaming- resentful and scowling at me. And later they say- 'Judge- thank you.'"

 

Acupuncture is the key element of the Addicts Changing Together Substance Abuse Program administered by the city's drug court. Beginning for women in 1993 and for men three years later- the program steers nonviolent offenders to a rigorous 45-day behind-bars regimen in lieu of a longer prison sentence.

 

In addition to 25 acupuncture sessions- inmates get group and individual counseling- GED training and life-skills classes. Recently- the program added a family mediation option for addicts who long ago burned family bridges but want to mend them.

 

Participants reside in a separate dorm at the Baltimore City Detention Center- away from the general population- and are encouraged to rely on each other for support.

 

The theory behind the acupuncture treatment is that it releases naturally occurring chemicals in the body that ease the symptoms of drug withdrawal and help users fight their addiction.

 

An acupuncturist places superfine stainless-steel needles in five points in the outer ear- each one designed to evoke a particular feeling- from calming the spirit to acceptance to reminding a person of his own willpower. The recipient then sits quietly for 30 to 40 minutes. Lights are dimmed- and soft music plays to promote meditation.

 

Eastern medicine experts say what is at work is not just New Age wishful thinking.

 

The treatment causes the body to release feel-good chemicals called endorphins- which go to the same receptors in the brain that are turned on when someone takes drugs- says Dr. Lixing Lao- director of the traditional Chinese medicine program at the University of Maryland's Center for Integrative Medicine.

 

The technique works to treat pain in the same way- says Lao- who works closely with Maryland Shock Trauma Center- treating patients who have been critically injured.

 

"The concept is very obvious-" he says. "If acupuncture works for pain- it should work for heroin addiction."

 

In the 1970s- doctors in a New York hospital began trying the ancient technique to treat heroin addiction. Since then- acupuncture centers have popped up around the world.

 

At a cost of $40-000 a year for all 688 inmates- the acupuncture portion of the city jail program is cheap by most treatment standards. But its supporters stress that it must be used with counseling and other services to be effective.

 

The state Division of Correction does not track inmates after they complete the program and does not keep data on whether addicts stay clean. But Mohammad Riaz Ahmad- the program's director- points to studies elsewhere that suggest acupuncture's effectiveness. A Yale University study found that 55 percent of participants tested free of cocaine during the last week of acupuncture treatment- compared with 24 percent and 9 percent in two groups that did not have acupuncture. But a follow-up study contradicted the earlier findings- and researchers said the topic needs more research.

 

A 2001 study of an acupuncture program at Baltimore's Penn North Neighborhood Center found that nearly a third of patients stayed in the program for at least 30 sessions- or about three months- and that their rate of being arrested and charged decreased.

 

"We are not saying it's curing addiction - there is no cure for addiction-" says Dave Wurzel- a certified acupuncturist whose firm does the jail's treatments. "Just like there is no cure for heart disease or diabetes. All we are doing in addiction treatment is lowering the risk factor that this person will die today of his or her addiction."

 

Officials with the jail program say the big problem comes when it's time for participants to be released.

 

About 80 percent of inmates who complete the program need the structured support of a residential treatment facility for as long as a year afterward- officials say. But demand for such treatment is so great that the facilities don't bother to keep a waiting list- says Gregory C. Warren- who heads Baltimore Substance Abuses Systems- the quasi-governmental agency that oversees drug treatment in the city.

 

So graduates of the acupuncture program are often referred to outpatient programs instead of residential centers. And if even those slots are full- the inmates sometimes must be held in the general prison population for up to several weeks until a treatment space opens up.

 

"If it's one day- it's bad-" says Danny McCoy- the detention center's assistant warden. "Back inside the institution- they are encountering all the things and people that would defeat the purpose of all they have learned in the treatment process."

 

The lure of the street is even worse- says Brooks- who took part in the jail's acupuncture program a decade ago. He stayed clean for six years.

 

He had started selling drugs at age 12- the same year his mother moved in with her boyfriend and left him to largely fend for himself. At 17- he snorted heroin for the first time.

 

But after his first stint in the acupuncture program- he felt transformed. He fell in love- got married and had a baby boy. Brooks worked two jobs and the family lived in a house they rented but hoped to buy.

 

Eventually- though- he started hanging out with old friends in the drug game- and stopped going to church and to Narcotics Anonymous meetings. One day- he tried a "tester" of heroin being hawked on a corner. Just one hit- he thought. By the time he was arrested last year- he was doing $200 a day worth of dope.

 

"I gave back six years in three seconds-" he says- wiping away tears. "Why? Please don't ask me that. That's why I'm here now- trying to figure out why."

 

Brooks graduates this week- complete with a cap- gown and celebration. But he doesn't want any accolades. He knows his biggest accomplishment lies ahead.

 

"When I get back in society- that's when the real test comes-" he says. "This is nothing compared to what I got to do."

 

Copyright 2009 Baltimore Sun.

 

 

 

 

Searching for a Cure-All

Human Genome Sciences' Future Rides on Success of New Treatments

 

By V. Dion Haynes

Washington Post

Monday- March 23- 2009; D01

 

Rockville-based Human Genome Sciences is still reeling from Wall Street's unexpected drubbing earlier this month in reaction to the biotech company's long-awaited study of a hepatitis C drug it is developing for a mass market.

 

The late-stage clinical trial showed that the drug- called Albuferon- requires hepatitis C patients to take injections only half as often as with a competing product used to treat the liver ailment. That's good news for patients- who would be subject to nasty flu-like side effects accompanying the injections much less often.

 

But the disappointing news was that the drug is effective in about one out of two patients tested -- a success rate that is no better than another hepatitis C treatment already on the market. The company- whose stock price plunged 67 percent- to 55 cents a share- with the news- is seeking to win back Wall Street with the forthcoming results from the trial of a drug it is developing for the auto-immune disease lupus.

 

"We're confident that should [Albuferon] be approved- we will have a successful product -- a leader in the treatment of hepatitis C-" said H. Thomas Watkins- the company's president and chief executive.

 

But Jason Kolbert- managing director of health-care research at ThinkEquity in New York- said he was dismayed that many patients opted out of the study- an indication to him that they were dissatisfied with the treatment. "If more people are dropping out- that defeats the purpose- which is to have a more tolerable drug."

 

Kolbert said he is fearful the company may not get government approval for the drug and said that it would be disastrous given the firm's $400 million in convertible notes due within the next few years. If Human Genome Sciences does not market the drugs before the notes are due- he added- "we're worried that the company lacks cash flow to pay off that debt and that it could get into trouble."

 

The difficulties facing Human Genome Sciences are replicated throughout the pharmaceutical and biotech industries- which are under increasing pressure to garner huge profits from their drug treatments to recoup hundreds of millions of dollars in research and development costs. The process- which takes a dozen or more years- is becoming more competitive and more expensive. Moreover- analysts say the Obama administration's proposals to curb health-care costs -- including encouraging the use of generic drugs over expensive name-brands -- would make it more difficult for the companies to make money.

 

"Biopharmaceutical" companies- which develop their medicines by chemical or biological means- spend five times as much as their counterparts in other industries on research and development- according to the Congressional Budget Office. The cost- coupled with the economic downturn- has sparked widespread mergers and job cuts among drug companies.

 

In recent months- Roche completed its takeover of Genentech- an effort aimed at consolidating their cancer programs. Pfizer acquired Wyeth- becoming the nation's largest pharmaceutical company. Merck merged with Schering-Plough- a plan aimed at diversifying its operations and cutting costs by eliminating up to 16-000 jobs.

 

Human Genome Sciences was established in 1992- sparked by the international effort to identify all 20-000 genes in human DNA. Working in second-floor labs in a mirror-glass building in Rockville- scientists harvest cell cultures for use in drugs aimed at combating anthrax- hepatitis C- lupus- diabetes- cardiovascular disease and cancer.

 

Despite the debt- company officials say they believe their balance sheets are in good shape. The company sold its property and is leasing it back- a deal that generated $380 million. The company this year will earn $155 million from a contract with the federal government to produce an anthrax antidote and is looking to secure additional orders. And the company has the potential to earn hundreds of millions of dollars in royalties from GlaxoSmithKline once a cardiovascular drug it is developing based on Human Genome Sciences' technology goes to market.

 

Company officials say they will seek Food and Drug Administration approval for the hepatitis C drug this year and the lupus drug next year. Given the cold response the hepatitis C medication received from Wall Street- company officials say they recognize the need to wow critics with their lupus drug.

 

Lupus- largely diagnosed in young women- causes the immune system to attack bodily systems- such as the skin- kidneys- lungs and brain. Patients suffer from a variety of symptoms- including fatigue- rashes and renal disease.

 

Currently- there is no drug developed specifically for lupus. Doctors typically treat patients with chemotherapy and steroids- which have shown decidedly mixed results in controlling lupus. The treatments often have nasty side effects: weight gain- bone loss and infections.

 

The company's lupus drug- called LymphoStat-B- is designed to block the process in which the body produces antibodies that attack healthy cells. Early trials showed improvement in half the patients on the lupus drug compared with improvement in 30 percent of patients in the control group- officials said.

 

Terence C. Flynn- senior vice president for equity research and emerging biotechnology at Lazard Capital Markets- said the chances of the drug succeeding are small given recent failures of lupus drugs under development by Genentech and LaJolla Pharmaceuticals.

 

But Barry A. Labinger- Human Genome Sciences' executive vice president and chief commercial officer- disagreed.

 

"There's no good drug available for lupus-" he said. "From a regulatory and a market standpoint- a drug that shows a good benefit for patients with lupus will be welcomed" by consumers.

 

Copyright 2009 Washington Post.

 

 

 

 

Worcester Co. Developmental Center Employee Charged With Theft

 

By Kye Parsons

wboc.com

Monday- March 23- 2009

 

SNOW HILL- Md.- Police on Monday arrested a Worcester County Developmental Center employee accused of stealing from a mentally-challenged client under her care.

 

The Worcester County Bureau of Investigation says the arrest of 60-yea-rold Martha Fagan Anderson of Pocomoke City was the result of a month-long investigation into allegations of a theft scheme.

 

Police say investigators had received information that Anderson- an employee of the Worcester County Developmental Center in Snow Hill- had been stealing funds that were intended to go to a mentally-challenged county resident. According to police- Anderson employee's function was to assist clients with independent living.  A review of the records and receipts showed many discrepancies- according to police.

 

As a result of their investigation police arrested Anderson for theft scheme over $500. She was later released on her on recognizance.

 

Copyright 2009 wboc.com.

 

National / International

 

Judge Orders FDA to Reconsider Limits on Morning-After Pill for Minors

 

By Rob Stein

Washington Post

Monday- March 23- 2009

 

A federal court today ordered the Food and Drug Administration to reconsider the agency's controversial decision limiting non-prescription access to the morning-after pill Plan B to women age 18 and older.

 

U.S. District Judge Edward R. Korman ordered the FDA to make Plan B available to women age 17 and older within 30 days and to reconsider whether to make the drug available to women of all ages without a prescription.

 

In his 52-page decision- Korman said the "record is clear that the FDA's course of conduct regarding Plan B departed in significant ways from the agency's normal procedures regarding similar applications to switch a drug from prescription to non-prescription use."

 

Critics of the FDA's position hailed the ruling.

 

"We're very excited-" said Suzanne Novak- a senior staff attorney for the Center for Reproductive Rights- which filed a lawsuit against the agency to reverse the 2005 decision.

 

"The message is clear: The FDA has to put science first and leave politics at the door. We are encouraged that the FDA under new leadership- when they look at the evidence- will remove the unique barriers that have been in place and it will finally be available to all women without any barriers-" Novak said.

 

Copyright 2009 Washington Post.

 

 

 

 

Study Finds Eating Red Meat Contributes to Risk of Early Death

 

By Rob Stein
Washington Post
Monday- March 23- 2009

 

Eating red meat increases the chances of dying prematurely- according to a large federal study that offers powerful new evidence that a diet that regularly includes steaks- burgers and pork chops is hazardous to your health.

 

The study of more than 500-000 middle-age and elderly Americans found that those who consumed the equivalent of about a small hamburger every day were more than 30 percent more likely to die during the 10 years they were followed- mostly from heart disease and cancer. Sausage- cold cuts and other processed meats also increased the risk.

 

Previous research had found a link between red meat and an increased risk of heart disease and cancer- particularly colorectal cancer- but the new study is the first large examination of the relationship between eating meat and overall mortality.

 

"The bottom line is we found an association between red meat and processed meat and an increased risk of mortality-" said Rashmi Sinha of the National Cancer Institute- who led the study published today in the Archives of Internal Medicine.

 

In contrast- routine consumption of fish- chicken- turkey and other poultry decreased the risk of death by a small amount- the study found.

 

Although pork often is promoted as "white meat-" it is believed to increase the risk for cancer because of its iron content- Sinha said. It is often grouped with red meat in nutritional studies.

 

"This would be the Rolls Royce of studies on this topic-" said Barry M. Popkin- a professor of global nutrition at the University of North Carolina- who wrote an editorial accompanying the study. "This is a slam-dunk to say that- 'Yes- indeed- if people want to be healthy and live longer- consume less red and processed meat.' "

 

There are many explanations for how red meat might be unhealthy: Cooking red meat generates cancer-causing compounds; red meat is also high in saturated fat- which has been associated with breast and colorectal cancer; and meat is also high in iron- which also is believed to promote cancer. People who eat red meat are more likely to have high blood pressure and cholesterol- which increases the risk of heart disease. Processed meats contain substances known as nitrosamines- which have been linked to cancer.

 

Regardless of the mechanism- the research provides new evidence that people should follow long-standing recommendations to minimize red meat consumption- several experts said.

 

"The take-home message is pretty clear-" said Walter Willett- a nutrition expert at the Harvard School of Public Health. "It would be better to shift from red meat to white meat such as chicken and fish- which if anything is associated with lower mortality."

 

The American Meat Institute- a trade group- dismissed the findings- however- saying they were based on unreliable self-reporting by the study participants.

 

"Meat products are part of a healthy- balanced diet- and studies show they actually provide a sense of satisfaction and fullness that can help with weight control. Proper body weight contributes to good health overall-" James H. Hodges- the group's executive president- said in a written statement.

 

For the study- researchers analyzed data collected from 545-653 volunteers- ages 50 to 71- participating in the National Institutes of Health-AARP Diet and Health Study. In 1995- the subjects filled out detailed questionnaires about their diets- including their meat consumption. Over the next 10 years- 47-976 men and 23-276 women died.

 

After accounting for other variables that might confound the findings- such as smoking and physical activity- the researchers found that those who consumed the most red meat -- about a quarter-pound a day -- were more likely to die of any reason- and from heart disease and cancer in particular- than those who consumed the least -- the equivalent to a couple of slices of ham a day.

 

Women who ate the most red meat were 36 percent more likely to die for any reason- 20 percent more likely to die from cancer and 50 percent more likely to die from heart disease. Men who ate the most meat were 31 percent more likely to die for any reason- 22 percent more likely to die of cancer and 27 percent more likely to die of heart disease.

 

In contrast- those who consumed the most white meat were about 8 percent less likely to die during the study period- the researchers found. Poultry contains more unsaturated fat- which improves cholesterol levels- and fish contains Omega-3 fatty acids- which are believed to help reduce the risk of heart disease.

 

The risk was also elevated among those who consumed the most processed meat- which included any kind of sausage- cold cuts or hot dogs. Women who consumed the most processed meat- about an ounce a day- were about 25 percent more likely to die overall- about 11 percent more likely to die of cancer and about 38 percent more likely to die from heart disease. The men who ate the most processed meat were 16 percent more likely to die for any reason- about 12 percent more likely to die of cancer and about 9 percent more likely to die of heart disease.

 

Experts stressed that the findings do not mean that people need to eliminate red meat from their diet but instead should avoid eating it every day.

 

"You can be very healthy being a vegetarian- but you can very healthy being a non-vegetarian if you keep your red meat intake low-" Willett said. "If you are eating meat twice a day and can cut back to once a day there's a big benefit. If you cut back to two or three times a week there's even more benefit. If you eliminate it entirely- there's a little more benefit- but the big benefit is getting away from every day red meat consumption."

 

In addition to the health benefits of reducing red meat consumption- a major reduction in meat consumption would probably have a host of other benefits to society: reducing water shortages and pollution- cutting energy consumption- and tamping down greenhouse gas emissions -- all of which are associated with large-scale livestock production.

 

"There's a big interplay between the global increase in animal food intake and the effects on climate change-" Popkin said. "If we cut by a few ounces a day our red meat intake- we would have big impact on emissions and environmental degradation."

 

Copyright 2009 Washington Post.

 

 

 

 

EPA: Global Warming Threatens Public Health- Welfare

 

By Juliet Eilperin

Washington Post

Monday- March 23- 2009

 

The Environmental Protection Agency sent a proposal to the White House on Friday finding that global warming is endangering the public's health and welfare- according to several sources- a move that could have far-reaching implications for the nation's economy and environment.

 

The proposal -- which comes in response to a 2007 Supreme Court decision ordering EPA to consider whether carbon dioxide and other greenhouse gases should be regulated under the Clean Air Act -- could lay the groundwork for nationwide measures to limit such emissions. It reverses one of the Bush administration's landmark environmental decisions: In July 2008 then-EPA administrator Stephen Johnson rejected his scientific and technical staff's recommendation and announced the agency would seek months of further public comment on the threat posed by global warming pollution.

 

"This is historic news-" said Frank O'Donnell- who heads the public watchdog group Clean Air Watch. "It will set the stage for the first-ever national limits on global warming pollution. And it is likely to help light a fire under Congress to get moving."

 

But business groups decried the move as an economic disaster.

 

"By moving forward with the endangerment finding on greenhouse gases- EPA is putting in motion a set of decisions that may have far-reaching unintended consequences-" said Bill Kovacs- vice president of environment- technology and regulatory affairs at the U.S. Chamber of Commerce. "Specifically- once the finding is made- no matter how limited- some environmental groups will sue to make sure it is applied to all aspects of the Clean Air Act.

 

"This will mean that all infrastructure projects- including those under the president's stimulus initiative- will be subject to environmental review for greenhouse gases. Since not one of the projects has been subjected to that review- it is possible that the projects under the stimulus initiative will cease. This will be devastating to the economy."

 

In December 2007 EPA submitted a written recommendation to the White House urging the Bush administration to allow EPA to state officially that global warming is a threat to human welfare. But senior White House officials refused to open the document and urged Johnson to reconsider- saying such a finding would trigger sweeping regulatory requirements under the 45-year-old Clean Air Act. An EPA analysis had found the move would cost utilities- automakers and others billions of dollars while also bringing benefits to other economic sectors.

 

EPA officials could not be reached immediately today for comment on the proposal.

 

Several congressional Democrats had urged EPA administrator Lisa P. Jackson to move ahead with an endangerment finding on the grounds that it was scientifically warranted and would help push Congress to enact a national cap on greenhouse gases. Unlike President George W. Bush- President Obama backs such mandatory limits.

 

On Thursday Sen. Barbara Boxer (D-Calif.)- who chairs the Environment and Public Works Committee- said- "There is no question that the law and the facts require an endangerment finding- and it should happen without further delay- and I believe it will."

 

Copyright 2009 Washington Post.

 

 

 

 

Reducing Hospital Infections- Late-Term Abortion Trial and Rising Vasectomy Rates

 

By Roni Caryn Rabin

New York Times Morning Rounds

Monday- March 23- 2009

 

Mentally Ill Affecting Safety of Nursing Homes

Mentally ill patients of all ages are being dumped in the nation's nursing homes- where they have been responsible for several beating deaths- the rape of a 69-year-old by a young man with bipolar disorder and a history of violence- and a Connecticut fire that killed 16 people- according to an Associated Press investigation. Nearly 125-000 young and middle-aged adults with serious mental illness lived in nursing homes in the United States last year- according to the report.

 

New Hospital Gown Disposal Method Reduces Infection Rates

Balling up a used hospital gown and stuffing it into a glove about to be discarded is one of several techniques that has helped reduce infection rates at hospitals around the United States- Reuters reports. The innovation was one of several discussed by infection control experts at a meeting in San Diego on Saturday.

 

Vasectomies on the Rise

Some doctors are reporting an uptick in vasectomies that may be related to the economy- HealthDay News reports. Doctors speculate that people want to limit family sizes- and they're rushing to undergo elective medical procedures before jobs or health insurance run out.

 

Trial Begins for Late-Term Abortion Doctor

Testimony starts today in the Wichita- Kan.- trial of a physician charged with performing late-term abortions without getting a second opinion from an independent doctor as required by law- according to news reports. The physician- Dr. George Tiller- has been a lightning rod for the anti-abortion movement for years and has been the target of protests- a bombing and a shooting.

 

Lawsuit Won in Polio Case

A Staten Island man with polio has won a multimillion dollar lawsuit against drug maker Lederle Laboratories- after claiming he contracted polio 30 years ago shortly after his daughter was vaccinated- The Daily News reports. Dominick Tenuto was awarded $22.5 million last week; the lawsuit claimed the oral vaccine passed through his daughter's body and infected Mr. Tenuto while he was changing a diaper.

 

Copyright 2009 The New York Times Company.

 

 

 

 

Vital Signs - Childhood: Combing Through Wet Hair May Be Best Way to Find Lice

 

By Nicholas Bakalar

New York Times

Monday- March 23- 2009

 

Figuring out whether a child has head lice may require more than just taking a look.

 

German scientists examined 304 children at five primary schools that reported persistent head lice infestations. First- a researcher examined their scalps- parting the hair at five places where eggs or lice are often found. Then a different investigator- unaware of the results of the first test- examined the same children- this time wetting the hair with conditioner and running a fine-tooth comb from the scalp to the end of the hair. The results appear in the March issue of The Archives of Dermatology.

 

Visual inspection found eggs or nits — that is- evidence of prior infestation — in 68 of the 300 children- while wet combing found such evidence in 54- so visual inspection was quite good at finding the eggs. But living lice are the moving transmitters of the epidemic- and visual inspection found only 6 cases- while wet combing found 19. In other words- the odds of finding moving lice were about three times higher with wet combing.

 

“Interrupting the epidemic means finding out who is infectious and who is not-” said Dr. Hermann Feldmeier- the senior author and a professor of microbiology at Charité University Medical School in Berlin. “For this purpose- the only suitable diagnostic technique is wet combing.”

 

Copyright 2009 The New York Times Company.

 

 

 

 

South Africa tries treating TB patients at home

 

Associated Press

By Clare Nullis

Washington Post

Monday- March 23- 2009

 

CAPE TOWN- South Africa -- South Africa is trying a new approach to controlling drug-resistant tuberculosis _ treating people at home rather than in isolation hospitals surrounded by barbed wire and baton-wielding guards- health officials said Monday .

 

South Africa has one of the world's highest rates of TB because of its AIDS epidemic. People with HIV are more likely to contract tuberculosis because of their weakened immune systems.

 

Existing policy is to forcibly confine patients with drug-resistant TB for around two years.

 

But health authorities in Cape Town said that this is unrealistic because of the sheer numbers of patients. They have joined with the charity Doctors Without Borders- also known as Medecins Sans Frontieres- on a pilot project to care for people at home.

 

"What we are piloting here is the best compromise to give some decency and respect to patients who are facing this terrible illness-" Eric Goemaere- medical coordinator in South Africa for the charity told reporters.

 

The poor suburb of Khayelitsha- where the pilot project is taking place- has 1-500 cases of TB per 100-000 people _ nearly four times the level classed as an emergency by the World Health Organization.

 

Many people tire of taking TB drugs for the necessary six months before the disease is completely cured and this has led to the explosion in the drug-resistant strain which has increased from 6-000 in 2002 to 14-000.

 

Goemaere said that health workers had detected around 200 cases of drug resistant TB last year in Khayelitsha- which has a population of half a million- but said the true figure was much higher.

 

"We only know about the tip of the iceberg-" he said.

 

Given the sheer numbers involved- prolonged hospital confinement is simply unrealistic- according to Goemaere. Far too many people die while waiting for a bed and to get on to treatment. Even more die before they are diagnosed as being sick.

 

There have been regular incidents of patients staging violent attempts to break through cordons of security guards at two of South Africa's most notorious hospitals. Some patients have succeeded in absconding and have been hidden by their families- prompting police to stage door-to-door searches. Staff are reluctant to work on the wards- saying the patients have attacked them and constantly threatened to spit their infectious germs into their faces.

 

But treatment at home is far from straightforward. All family members have to be screened for the disease and health workers specially trained- and people have to be meticulous in wearing a face mask.

 

Virginia Azevedo- a doctor with Cape Town's health department- said there had been some cases of children infected by a family member being treated at home but it was too early to draw conclusions.

 

The pilot study _ which has the blessing of the national government _ is expected to run for at least another two years. But initial results have been encouraging- with an increase in the number of TB cases diagnosed and an increase in patients sticking to the treatment- according to Azevedo.

 

Busisiwe Beko- 35- was diagnosed with drug-resistant TB in February 2006 and discovered that she had infected her infant daughter. Beko- who was also infected with HIV- like many TB sufferers- was put on a waiting list for a hospital bed.

 

"I felt that if I went to hospital ... I would go and die in there-" she said.

 

By then she was desperately ill and so started treatment for both the drug-resistant TB and AIDS at home- wearing a mask to prevent her from infecting her family and keeping windows open to ensure maximum circulation of fresh air.

 

She said support from her loved ones helped her survive six months of painful daily injections and 18 months of "horrible drugs" that made her vomit daily.

 

"You can get cured- that is the message I am spreading-" said Beko- who is now a counselor with Medecins Sans Frontieres.

 

© 2009 The Associated Press.

 

 

 

 

WHO: Money- drugs needed to rein in new TB strains

 

Associated Press

By Gillian Wong

Washington Post

Monday- March 23- 2009

 

BEIJING -- More money and better science are urgently needed to rein in new strains of tuberculosis that are tough or nearly impossible to treat- the WHO announced Monday in China- where the disease has long been a leading killer.

 

The World Health Organization is releasing its annual update on tuberculosis on Tuesday- which is also World TB Day- an event meant to raise awareness of a disease that despite being one of the world's oldest killers still claims the lives of more than 1.5 million people every year. About 9 million people are infected- most in Africa and Asia.

 

"Drug-resistant tuberculosis is a growing global public health threat. We are at a turning point. We need to address it-" Dr. Cornelia Hennig- the WHO's TB program coordinator for China- said at a news briefing in Beijing.

 

The report comes a week before the start of an international conference in Beijing focusing on ways to deal with drug-resistant TB strains. India- China and Russia _ the three countries with the world's highest number of drug-resistant TB cases _ will participate.

 

Hennig said the spread of drug-resistant TB strains can be prevented by spending more on TB control programs and coming up with better medical tests and drugs.

 

Drug-resistance develops when patients are not treated properly or interrupt their treatment after they start feeling better- giving bacteria an opportunity to develop a defense against the medicines.

 

Multidrug-resistant TB- or MDR-TB- doesn't respond to at least two of the best anti-TB drugs. Extensively drug-resistant TB- known as XDR-TB- is virtually untreatable by remaining options.

 

"Our treatment options are very- very restricted. ... We almost have no weapon to treat XDR-TB-" Hennig said. "Recognition that XDR is a threat is becoming more and more the message."

 

In 2007- there were an estimated 511-000 cases of multidrug-resistant TB in the world- resulting in more than 130-000 deaths- Hennig said- while about 30-000 people likely died from extensively drug resistant TB out of 50-000 cases.

 

In China- tuberculosis was the deadliest infectious disease for many years until last year- when AIDS became the top killer for the first time.

 

© 2009 The Associated Press.

 

 

 

 

China Clears J&J in Probe of Baby-Product Chemicals

 

By Loretta Chao

Wall Street Journal

Monday- March 23- 2009

 

BEIJING -- Chinese health authorities said Johnson & Johnson baby products were safe to use- concluding investigations of claims by a U.S. activist group that the products contained cancer-causing chemicals.

 

China's State Food and Drug Administration said on its Web site Saturday that it concluded after inspections that formaldehyde and 1-4-dioxane weren't used as additives in dozens of J&J baby products sold in China. China's state-run Xinhua news agency reported Saturday that the General Administration of Quality Supervision- Inspection and Quarantine also cleared the products.

[China Clears J&J Baby-Products] Associated Press

 

Beijing has rejected objections by activists to J&J baby products. Above- an infant in Xiangfran in central China.

 

Last week- Shanghai-based Nonggongshan Supermarkets Corp. pulled J&J's baby products from the shelves of the supermarket chain's 3-500 stores in China- after a report by Campaign for Safe Cosmetics said trace levels of formaldehyde and 1-4-dioxane found in the products were unsafe for children because the chemicals can cause cancer.

 

J&J- based in New Brunswick- N.J.- has denied the group's allegations- saying both chemicals are safe in trace amounts and that the company's products were in compliance with safety laws in all the countries where it sells them.

 

Campaign for Safe Cosmetics- a coalition of American nonprofit organizations- is urging J&J to reformulate its products to exclude the chemicals anyway.

 

Gan Pingzhong- director of Nonggongshan's quality-inspection department- said Sunday the supermarket chain had resumed sales of the products after authorities cleared them.

 

J&J is the largest seller of infant skin lotions and other baby-care products in China- with 69% of the $395 million market by revenue last year- according to market-research firm Euromonitor International.

 

Formaldehyde- often used as a preservative in cosmetics- is permitted for use in cosmetics in China to a maximum concentration of 0.2%- according to the State Food and Drug Administration. Its statement said 1-4-dioxane- a common byproduct in the manufacturing process for cosmetics- is banned as an additive in cosmetics- but the Xinhua report said the chemical isn't otherwise regulated in China.

-Kersten Zhang contributed to this article.

 

Copyright 2008 Dow Jones & Company- Inc. All Rights Reserved.

 

Opinion

 

Costly Home Health Care

 

New York Times Editorial

Monday- March 23- 2009

 

Health care reformers have long advocated providing more care to patients in their own homes or communities instead of treating them in costly institutions like hospitals and nursing homes. So it is disturbing to learn that charges have risen well above reasonable levels in one segment of the home health care market — short-term care provided to Medicare beneficiaries after- or sometimes instead of- hospitalization. The problem is compounded by fraud.

 

In its annual report to Congress this month- the Medicare Payment Advisory Commission- a group of independent experts- concluded that home health agencies have been paid significantly more than their cost of providing the services in recent years. Their average margins were about 16.5 percent a year between 2002 and 2007- and- even after some rate adjustments- are expected to exceed 12 percent this year in the midst of a recession. Experts say there is room to reduce payments substantially without harming the provision of such services as skilled nursing care- physical or occupational therapy- speech therapy and medical social work.

 

The overpayment problem is exacerbated by fraud and manipulation- according to a report issued recently by the Government Accountability Office. The G.A.O. looked at seven states that experienced the highest growth rate in Medicare home health expenditures from 2002 through 2006 and found a substantial number of abuses. These included overstating a beneficiary’s condition to get an improperly high reimbursement- billing for patients who were not homebound and thus not eligible for home health care- and making unnecessary visits.

 

Some of the worst abuses were in Texas and Florida- where spending growth was highest. In Houston- more than 90 percent of the beneficiaries reviewed in one audit had improperly been given the most severe clinical rating. In Miami-Dade County- a disproportionately high number of diabetics were getting skilled nursing visits every day to administer their insulin shots despite lack of evidence that they needed any help; some were coached on how to lie about their need for assistance.

 

Federal officials are taking steps to reduce fraud- and Congress is pushing them to do more. The bigger cost issue — paying too much across the board for home health services to Medicare beneficiaries — would largely be solved by President Obama’s budget proposals. His budget plan calls for saving a hefty $37 billion over the next decade by reducing Medicare’s projected home health care expenditures in order to help finance his broader health care reforms.

 

Home health care companies are already complaining that the cuts will hurt patients- but their industry is one of the most profitable parts of Medicare; it needs to do its fair share to curb the relentless surge in Medicare spending. If the nation’s health system is to move toward greater reliance on home care- it needs to be sure it is paying the right price.

 

Copyright 2009 The New York Times Company.

 

 

 

 

Food for Thought

The president appoints a working group to improve food safety.

 

Washington Post Editorial

Monday- March 23- 2009; A14

 

SINCE 2006- the concept of food safety- as practiced by the federal government- has seemed oxymoronic. The recent concern about contaminated peanuts is but the latest in a series of food scares that included salmonella outbreaks involving tomatoes- peppers and spinach. With each occurrence- Congress thundered about the need to fix the way the nation safeguards its food supply- but little was done. Maybe more will happen now that President Obama has formed a Food Safety Working Group and selected a top-notch team to lead the Food and Drug Administration.

 

A congressional hearing on tainted peanuts last week unearthed more reasons for queasiness. The private inspection company hired by Peanut Corporation of America (PCA) warned it of impending visits- giving the company plenty of time to tidy up what federal inspectors and others found during unannounced inspections: rat droppings- dead insects and rodents- and other unsanitary conditions. The troubles at PCA are symptoms of larger problems that need to be addressed.

 

Aside from increasing the number of federal inspectors and the frequency of visits they make to the country's nearly 150-000 food facilities- a number of good ideas are kicking around the Capitol. Rep. Diana DeGette (D-Colo.) would give the FDA authority to issue mandatory recalls for contaminated food -- no more relying on the goodwill of businesses that might be tempted to put the bottom line above the public health -- and would require it to devise a system to trace food and produce from the farm to the dinner table. Legislation from Rep. Rosa DeLauro (D-Conn.) would require companies to test for the hazards that are most likely to occur in their products and then have the federal government devise standards for what constitutes a hazard.

 

The Food Safety Working Group will include Margaret A. Hamburg and Joshua Sharfstein. Dr. Hamburg- a highly regarded former New York City health commissioner and assistant secretary for health and human services under President Bill Clinton- was tapped by Mr. Obama to be the next FDA commissioner. The president nominated Dr. Sharfstein- Baltimore's health commissioner- to be the FDA's principal deputy commissioner. Congress should move quickly to confirm them so they can get to work.

 

Copyright 2009 Washington Post.

 

 

 

 

Active kids

 

Cumberland Times-News Editorial

Monday- March 23- 2009

 

If the nation’s childhood obesity problem is ever brought under control- it will likely be because kids are finally forced out of the house for some play time.

 

“Nowadays- kids aren’t playing in the streets and hanging out and having a good time. They’re sitting in front of video games- they’re eating a lot of fast foods-” Washington Redskins cornerback DeAngelo Hall said last week.

 

Hall was one of seven National Football League players to speak out in favor of the FIT Kids Act — legislation that would require all schools and states to report on students’ physical activity- and to give youngsters health and nutritional information.

 

The legislation is being sponsored by Rep. Ron Kind- D-Wis.- a former Harvard quarterback.

 

While it is commendable that lawmakers are trying to encourage physical fitness among children- the real remedy lies at home.

 

The Centers for Disease Control and Prevention have a number of suggestions on how to spur kids into action. First on the list is for adults to set a positive example by leading an active lifestyle themselves.

 

Rather than watching television or playing video games after dinner- children should be encouraged to find fun activities to do on their own or with family friends. Walking- playing catch or bicycling are just a few possibilities.

 

As Baltimore Ravens special teams star Brendon Ayanbadejo said- “We need kids playing 60 minutes a day.”

 

Copyright © 1999-2008 cnhi- inc.

 

 

 

 

A prescription for healthy babies

 

By Jay Wolvovsky

Baltimore Sun Commentary

Monday- March 23- 2009

 

Lack of health insurance drives many people to under- and over-utilize health services in ways that are costly to taxpayers and damaging to their long-term health. The ranks of the uninsured are swelling each day- and we can expect the human and financial costs of inadequate preventive and primary care to rise in proportion. Recent local reports have highlighted a classic example: our health financing system's shortsighted investment in acute care over preventive care.

 

This newspaper's recent call for expanding coverage for women who have had a poor pregnancy outcome does not go far enough. It focuses on intervening after the problem has manifested - too much in line with the flawed policy approach that has gotten us to where we are today.

 

The Baltimore Health Department reports that in 2007- Baltimore's overall rate for low-birthweight babies was 12.8 percent- and in Maryland the rate was 9.1 percent. At Baltimore Medical System- we delivered 1-497 babies last year; only 8.15 percent had low birthweights. Yet our patients represent all the highest-risk categories: the working poor- the newly immigrated- people living in long-term poverty and the unemployed.

 

A well-thought-out prescription for healthy babies would be comprehensive and truly preventive in its approach. It would include preventive care for all low-income families- including women before they become pregnant (and not forgetting fathers- who are marginalized by benefits that focus only on women). That system should be designed with incentives at the primary care level - the least costly and most holistic link in our fragmented health system. Such a system needs to embrace new immigrants as well- many of whom are not eligible for coverage within the current system until their date of delivery under an "emergency Medicaid" provision. There is no better way to make a birth an emergency- with all the ensuing negative consequences for the family and for society- than to not provide coverage until the date of delivery. And the cost of one day in a neonatal intensive care unit is more than the cost of providing care for the whole prenatal period.

 

How is a community health provider to keep meeting this growing need with grants that remain fixed at a static level and with limited space? The health care financing system puts us at risk at every step- with inadequate reimbursement of our basic health services and inadequate capital investment in our facilities.

 

It doesn't take a pilot study to show that if you give women access to comprehensive- accessible- affordable and culturally competent care- you can cut down on low birthweights and reduce all the attendant economic and human costs. What we need is health care reform- putting the money where the problem and the solution both lie - in community-based primary and preventive care. Anything less than a comprehensive approach toward prenatal services risks throwing good money after bad.

 

Copyright 2009 Baltimore Sun.

 

 

 

 

Right to rely less on group homes

 

Baltimore Sun Letter to the Editor

Monday- March 23- 2009

 

Over the past two years- the state has- to its credit- significantly reduced the number of children in group homes and is now correctly closing some homes to reduce the oversupply ("State to close 23 group homes-" March 18).

 

For far too long- the state has overused institutional placements for abused or neglected children- at great expense and with poor outcomes for the children.

 

It is important that the remaining group home providers be held accountable for moving more children to less-restrictive placements as quickly and effectively as possible. racts need to include clear- fair performance measures that reward group homes that do well and sanction those that do not.

 

The state could also help group home operators change their business model to provide more services to children in their group homes and also offer services to children in family foster care. From Maine to New York City- this kind of strategy has worked to reduce the overuse of group homes and to increase the array of services available to families in the community.

 

Overall- the state needs a transparent plan to safely reduce group home use and capture the savings to pay for community-based services.

 

So far- there is no such plan- and this may be one reason why the state has not seen a savings in its expenses for out-of-home placements despite the reduction in the number of group homes.

 

Matthew H. Joseph

Baltimore

 

The writer is executive director of Advocates for Children and Youth.

 

Copyright 2009 Baltimore Sun.

 

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